Additive manufacturing (AM) has developed rapidly into a technology enabling the creation of products with virtually limitless design geometries from an increasing number of materials spanning polymers, ceramics and metals. The innovative potential of AM is mirrored, in particular, by its impact on the medical manufacturing industry, which is supplying clinics with a steadily growing number of devices created by AM. The truly revolutionary and as yet completely unrealized potential of AM for medical applications lies, however, in the printing of
personalized implants directly in the clinic. Current treatment of fractures and/or lesions caused by trauma or tumour infiltration is often based on improvised usage of sub-optimal implants.
Complex pelvic fractures are, for example, fixed by intraoperative bending of standard metal plates to fit the fracture. The downsides of this are lengthy surgery and the creation of predetermined breaking points in the metal leading to later implant failure (and, thus, more surgery and attendant potential morbidity).
Ribs removed in the course of tumour resection are similarly replaced by relatively thin metal bands requiring intraoperative adaptation to patient specific curvature of the thorax. These
implants are, moreover, rigid in character and consequently eventually deformed by movement associated with breathing and the forces acting upon the thorax, necessitating
remedial surgery (often, multiple times).
Reconstruction following tumor-associated craniectomy automatically requires a second round of surgery because the customized implants used for this are currently produced by
external manufacturers (with a typical waiting time of six weeks). The potential benefits of customization in this case are, however, often forfeited due to changes to the shape of the
cranial opening that occur during the wait for the implant.
Additive manufacturing using optimized application-specific materials in the clinic itself would greatly improve overall outcome for these patients. It would, moreover, significantly reduce overall patient stress by obviating the need for a second surgical intervention (and others necessitated by possible complications).
Successful clinical implementation of AM will, however, necessitate the improvement and adaptation of key associated processes such as imaging, segmentation, material
development and the selection, in each case, of the most appropriate AM technology.
Subsequent developments will furthermore require effective integration of both the medical standpoint and the expertise of the (industrial) developers.
The CAMed project shall bring together clinicians, medical and material scientists and industry partners in a tightly networked, focused cooperation to develop AM-based processes for the clinical manufacture of custom-fit implants for specified medical
applications. Medical professionals and their patients will, as a result, begin to reap the enormous potential benefits of clinical 3D printing.